The course of anxiety symptoms in the 24 months after start of stroke rehabilitation and its relation with psychological care and unmet needs: an observational prospective cohort study.

IF 2.2 4区 医学 Q1 REHABILITATION
Daniëlla M Oosterveer, Desi Stokman-Meiland, Aleid de Rooij, Henk Arwert, Jorit Meesters, Thea P M Vliet Vlieland
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Abstract

Background: Anxiety after stroke is common and has a negative impact on quality of life but might be underdiagnosed or undertreated.

Objectives: To describe the course of anxiety symptoms post-stroke, and the relation with psychological care and unmet needs.

Methods: In an observational prospective cohort study, patients with stroke completed the Hospital Anxiety and Depression Scale (HADS) at 3, 6, 12 and 24 months after the start of rehabilitation; 1 item about psychological care; and the Longer-Term Unmet Needs after Stroke. Chi-square and Kruskal-Wallis tests were used to compare patients within three different trajectories of anxiety symptoms based on the HADS anxiety subscale: no (all times <8), non-consistent (one to three times ≥8) or persistent anxiety symptoms (all times ≥8).

Results: Six hundred and ninety patients were included (37.7% females, median age 62 years). At 3, 6, 12 and 24 months after baseline, 136/612 (22.2%), 129/586 (22.0%), 125/548 (22.8%), and 96/487 (19.7%) patients reported anxiety symptoms, respectively. There were 248/384 (64.6%) patients with no, 97/384 (25.3%) with non-consistent, and 39/348 (10.2%) with persistent anxiety symptoms. A minority of patients with non-consistent or persistent anxiety symptoms received psychological care. They had more unmet needs and more often an unmet need related to mood.

Conclusion: The prevalence of post-stroke anxiety remains around 20%, and in 10.2% of patients persistent anxiety symptoms were found. Optimization of screening and treatment seems of value.

卒中康复开始后24个月焦虑症状的病程及其与心理护理和未满足需求的关系:一项观察性前瞻性队列研究
背景:卒中后焦虑很常见,对生活质量有负面影响,但可能未得到充分诊断或治疗。目的:探讨脑卒中后焦虑症状的发生过程及其与心理护理和未满足需求的关系。方法:在一项观察性前瞻性队列研究中,卒中患者在康复开始后3、6、12和24个月完成医院焦虑和抑郁量表(HADS);心理护理1项;以及中风后长期未满足的需求。采用卡方检验和Kruskal-Wallis检验比较基于HADS焦虑亚量表的三种不同焦虑症状轨迹的患者:无(所有时间)结果:纳入690例患者(37.7%为女性,中位年龄62岁)。在基线后3、6、12和24个月,分别有136/612(22.2%)、129/586(22.0%)、125/548(22.8%)和96/487(19.7%)患者报告出现焦虑症状。248/384例(64.6%)患者无焦虑症状,97/384例(25.3%)患者有不一致焦虑症状,39/348例(10.2%)患者有持续焦虑症状。少数有不一致或持续焦虑症状的患者接受心理护理。他们有更多未满足的需求,而且更多的是与情绪相关的未满足需求。结论:卒中后焦虑的患病率仍在20%左右,10.2%的患者存在持续性焦虑症状。筛选和治疗的优化似乎很有价值。
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来源期刊
Topics in Stroke Rehabilitation
Topics in Stroke Rehabilitation 医学-康复医学
CiteScore
5.10
自引率
4.50%
发文量
57
审稿时长
6-12 weeks
期刊介绍: Topics in Stroke Rehabilitation is the leading journal devoted to the study and dissemination of interdisciplinary, evidence-based, clinical information related to stroke rehabilitation. The journal’s scope covers physical medicine and rehabilitation, neurology, neurorehabilitation, neural engineering and therapeutics, neuropsychology and cognition, optimization of the rehabilitation system, robotics and biomechanics, pain management, nursing, physical therapy, cardiopulmonary fitness, mobility, occupational therapy, speech pathology and communication. There is a particular focus on stroke recovery, improving rehabilitation outcomes, quality of life, activities of daily living, motor control, family and care givers, and community issues. The journal reviews and reports clinical practices, clinical trials, state-of-the-art concepts, and new developments in stroke research and patient care. Both primary research papers, reviews of existing literature, and invited editorials, are included. Sharply-focused, single-issue topics, and the latest in clinical research, provide in-depth knowledge.
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